Doctor prescribes the human touch

In an era of unprecedented medical advances, many patients remain deeply dissatisfied with the care they receive from physicians.

By Bill Kettler

In an era of unprecedented medical advances, many patients remain deeply dissatisfied with the care they receive from physicians.

Dr. Abraham Verghese says physicians too often tend to view their patients as the two-dimensional figure on the medical chart — what he calls the "I-patient" — rather than a sensitive human being seeking help.

"The patient in the bed has become an icon for the patient in the computer," Verghese said during a recent telephone interview.

Verghese, a physician who's written three books, including the critically acclaimed novel "Cutting for Stone," comes to Medford Feb. 8 to speak in conjunction with the "humane medicine" series at Rogue Valley Medical Center.

He'll speak at 7 p.m. in the Smullin Health Education Center, 2825 E. Barnett Road, Medford, on the topic of "Touching Where it Hurts — The Art of Medicine in a Technological Era."

Verghese said patients increasingly feel disconnected from the people who care for them, especially in hospitals. He said many physicians may be shortchanging the importance of the physical exam as a way to understand what's ailing their patients and connecting with them.

Physicians who bypass the physical exam may be depriving themselves of significant information that won't necessarily be provided by expensive technological diagnostic equipment.

"When you're skilled at the bedside in the hospital, and taking time to listen to the patient's story, you're a day and a half ahead of the doctor who's waiting for results to come back from the laboratory," he said.

That doesn't mean physicians should abandon technology, he said, but they must recognize its limits.

"I'm under no illusion my hand is as sensitive as a CAT scan," Verghese said, "but a CAT scan can't feel tenderness" the way a physician can when examining a patient.

Verghese said the health care system needs to find a way to make it more worthwhile for physicians to spend time listening to patients to help rein in costs.

"It's very clear when you spend a little more time (with patients), you don't do some (expensive) tests," he said.

He described certain aspects of the health care system as "corrupt." As examples, he cited patients who can't find out the cost of procedures in advance, and the business arrangements in which physicians own a share of diagnostic imaging centers and surgery centers to which they refer patients.

"How can you be objective about sending a patient for a CAT scan when you have ownership in it?" he said.

Changing the health care system will be challenging, Verghese said, because "every dollar spent in health care is a dollar of income for someone."

Verghese is senior associate chairman of the department of medicine and professor for the theory and practice of medicine at Stanford University School of Medicine. He has been publishing his writing since 1991, when a story he wrote appeared in The New Yorker magazine. His first book, "My Own Country," focused on his experience treating AIDS patients in rural Tennessee. His second book, "The Tennis Partner," is a story of friendship and personal loss.

"Cutting for Stone," his first novel, is the story of twin brothers born of a secret union between a beautiful Indian nun and a British surgeon in Ethiopia.

He said he was drawn to write a novel as a way of truth telling. Paraphrasing the writer Dorothy Allison, he said, "Fiction is the great lie that tells the truth about how the world is."